Radiofrequency dissection versus ‘knot tying’ in conventional total thyroidectomy

AbstractObjective:To evaluate the safety and effectiveness of radiofrequency dissection in conventional ‘open’ total thyroidectomy.Methods:Thirty-nine patients scheduled for conventional total thyroidectomy were included in a prospective randomised study. Patients were randomly assigned to one of two groups: a radiofrequency dissection method was used in one group, and a knot tying technique was used in the other.Results:Significantly fewer surgical instruments and materials were required for the radiofrequency dissection group than the knot tying group (p < 0.01). There were no significant differences between the two groups in mean operative time, blood loss, post-operative drainage and pain, recurrent palsy, and hypocalcaemia (p > 0.05).Conclusion:Radiofrequency dissection is a safe alternative to the knot tying technique, and enables a significant reduction in the number of surgical instruments required for the operation.

Download Full-text

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

International Surgery Journal ◽

10.18203/2349-2902.isj20192355 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1862

Author(s):

Mahmoud N. M. Ali ◽

Ahmed Abdelkahaar Aldardeer ◽

Ayman M. A. Ali ◽

Alaa A. Radwan

Keyword(s):

Total Thyroidectomy ◽

Randomized Study ◽

Conventional Technique ◽

University Hospital ◽

Recurrent Laryngeal Nerve Paralysis ◽

Knot Tying ◽

Nerve Paralysis ◽

Operative Outcomes ◽

Operative Drainage ◽

Knot Tying Technique

Background: Since the introduction of successful thyroidectomy no change occurred in the technique but with the innovation of sutureless surgery, sutureless thyroidectomy becomes a competitor for the conventional technique. In this study we tried to analyze the outcomes of each.Methods: This was a prospective cross armed uncontrolled randomized study included 65 patients suffering from non-malignant goiter who underwent total thyroidectomy, admitted to Sohag University Hospital from September 2017 to October 2018. Patients were randomly allocated into two groups; Group (S) managed with sutureless thyroidectomy, and Group (C) managed with conventional knot tying technique. The data of the patients were gathered and analyzed considering the operative and post-operative outcomes. All patients were followed-up for 6 -12 months.Results: We found a significantly shorter operative time (p=0.001), also the amount of intra-operative blood loss was highly significant less in Group S (p=0.001). There was higher incidence of post-operative pain in Group C (p<0.001), post-operative drainage volume was highly significantly less in Group S (p=0.001). Regarding post-operative complications; the incidence of recurrent laryngeal nerve paralysis (RLNP) was insignificant between both groups (p=0.38), in the same time the incidence post-operative transient hypocalcaemia was significantly more in Group C (P=0.025). The overall post-operative complication rate was significantly more in Group C (p=0.002). The duration of hospital stay was highly significant shorter in Group S (p=0.0001).Conclusions: The use of Harmonic FOCUS® is beneficial for both patient and surgeon; it is efficient and a trustable safe substitute to the conventional knot tying technique.

Download Full-text

Prospective randomised study using focus harmonic scalpel versus conventional hemostasis for vessel ligation in open thyroid surgery

International Surgery Journal ◽

10.18203/2349-2902.isj20171156 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1431 ◽

Cited By ~ 2

Author(s):

Anandaravi B. N. ◽

Mohammed Anwar Aslam ◽

Praveen P. Nair

Keyword(s):

Hospital Stay ◽

Total Thyroidectomy ◽

Operative Time ◽

Harmonic Scalpel ◽

P Value ◽

Group V ◽

Open Thyroidectomy ◽

Randomised Study ◽

Duration Of Hospital Stay ◽

Prospective Randomised Study

Background: The objective was to compare operative factors, postoperative and surgical complications of open thyroidectomy by using FOCUS harmonic scalpel (HS) versus conventional hemostasis.Methods: A prospective randomised study in which 34 patients with benign/malignant thyroid disease patients underwent open thyroidectomy, patients were randomised into two groups, Group -1(HS) - included 19 patients which FOCUS Harmonic scalpel was used exclusively, Group -2(CH) included 15 patients in which conventional hemostasis was used exclusively. We recorded operative time, postoperative blood loss and drain output, postoperative complications and duration of hospital stay, patients were watched for 48-72 hours following surgery. The results were analysed by using student’s t-test.Results: Mean operative time for hemithyroidectomy was 53.40±9.07 minutes in HS group versus 85.25±17.03 minutes in CH group (p-value -0.004) mean operative in patients who underwent near total thyroidectomy is 67.21±10.36 in HS group v/s 109.60±29.35ml in CH group (p-value 0.001), postoperative drain output in patients who underwent hemithyroidectomy in HS group is 16.00±15.16 v/s 36.25±4.78 ml in CH group (p-value 0.008), postoperative drain output in patients who underwent near total thyroidectomy in HS group is 28.21±16.36ml v/s 45.50±8.95ml in CH group(p-value 0.006),length of hospital stay is 3.28±1.06 days in HS group v/s 4.20±1.39days in CH group,(p-value-0.083), complications like temporary hypocalcemia was present in 1 patient in HS group v/s 3 patients in CH group ,temporary RLN palsy was present in 2 patients in each group, there were no cases of permanent RLN palsy in either group, neither were the cases of permanent hypoparathyroidism in either group.Conclusions: FOCUS Harmonic scalpel will reduce operative time, reduces the incidence of symptomatic hypocalcemia but not temporary hypocalcemia,reduces postoperative drain output, reduces the duration of hospital stay, and shows no significance on incidence of temporary/permanent RLN palsy. FOCUS harmonic scalpel supposed to be more reliable and safe instrument that can be used instead of conventional hemostasis techniques in open thyroidectomy.

Download Full-text